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Is serum total bilirubin useful to differentiate cardioembolic stroke from other stroke subtypes?
Insights
Serum total bilirubin (TB) levels are linked to cardioembolic stroke. Measuring TB may help diagnose this stroke type, especially when combined with clinical data.
Area of Science:
- Cardiology
- Neurology
- Biochemistry
Background:
- Total bilirubin (TB) levels correlate with heart diseases like atrial fibrillation.
- Heart diseases can lead to cardioembolic stroke via cerebral embolism.
- The utility of serum TB as a biomarker for differentiating cardioembolic stroke remains uncertain.
Purpose of the Study:
- To investigate the association between serum total bilirubin (TB) levels and cardioembolic stroke.
- To determine if serum TB can serve as a biomarker for identifying cardioembolic stroke subtypes.
Main Methods:
- Analysis of clinical and laboratory data from 628 ischemic stroke patients.
- Stratification of patients based on serum TB quartiles and stroke subtypes.
- Multivariable analysis to assess TB as an independent predictor of stroke.
Main Results:
- Higher TB quartiles were associated with atrial fibrillation and cardioembolic stroke (P < 0.001).
- Serum TB independently predicted cardioembolic stroke (OR = 1.091, P = 0.008).
- Elevated TB correlated with larger left atrium diameter and reduced left ventricular function.
Conclusions:
- Serum TB levels are independently associated with cardioembolic stroke.
- Combining clinical data with serum TB may aid acute diagnosis of cardioembolic stroke.
Background:
Previous studies have reported that the total bilirubin (TB) level is associated with coronary artery disease, heart failure and atrial fibrillation. These heart diseases can produce cardiogenic cerebral embolism and cause cardioembolic stroke. However, whether the serum TB could be a biomarker to differentiate cardioembolic stroke from other stroke subtypes is unclear.
Methods:
Our study consisted of 628 consecutive patients with ischaemic stroke. Various clinical and laboratory variables of the patients were analysed according to serum TB quartiles and stroke subtypes.
Results:
The higher TB quartile group was associated with atrial fibrillation, larger left atrium diameter, lower left ventricular fractional shortening and cardioembolic stroke (P < 0.001, P = 0.001, P = 0.033, P < 0.001, respectively). Furthermore, serum TB was a statistically significant independent predictor of cardioembolic stroke in a multivariable setting (Continuous, per unit increase OR = 1.091, 95%CI: 1.023-1.164, P = 0.008).
Conclusions:
Serum TB level was independently associated with cardioembolic stroke. The combination of clinical data and serum TB may be a feasible strategy to diagnose cardioembolic stroke in the acute phase.
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